Jin You Kim MD, Presenter: Nothing to Disclose

Nariya Cho MD, Abstract Co-Author: Nothing to Disclose

Woo Kyung Moon, Abstract Co-Author: Nothing to Disclose

Jung Min Chang MD, Abstract Co-Author: Nothing to Disclose

Won Hwa Kim MD, Abstract Co-Author: Nothing to Disclose

Su Hyun Lee MD, Abstract Co-Author: Nothing to Disclose

Breast MRI can detect contralateral cancers missed by mammography and physical examination. However, controversy remains over the clinical efficacy of preoperative MRI. Thus, we assessed whether bilateral preoperative MRI could reduce contralateral breast recurrence at long- term follow-up(FU).

In 2007, bilateral breast MRI replaced unilateral breast MRI in our institution. We compared the cancer detection rates of 705 consecutive unilateral breast MRI and 1083 bilateral breast MRI for women with newly diagnosed breast cancers. There were no significant differences in mean patient age (47.8, range 22-81 years vs 48.4, range 21-85 years, P= .135) and surgical stage (stage 0, 10% vs 14%; stage I, 39% vs 38%; stage II, 40% vs 37%; stage III, 11% vs 11%, P= .072) between the two groups. Absence of cancer in the contralateral breast was determined by means of biopsy and absence of positive findings on imaging at 12 month FU. Median FU duration was 48 months (range: 12-67 mo) for the unilateral scan group and 29 months (range: 12-39 mo) for the bilateral scan group.

At the time of preoperative evaluation, contralateral cancers detected by mammography and physical examination were similar between the two groups [0.4% (3/705) vs 1.2% (13/1083), P=.122]. However, 15 additional cancers were detected by MRI in the bilateral scan group [0% (0/705) vs 2.6% (15/1083), P< .001]. Long-term FU revealed that the number of contralateral breast cancer diagnoses in unilateral scan group was greater than that in the bilateral scan group [1.0% (7 of 705) vs 0.3% (3 of 1083), P=.057] with borderline significance. Median interval between initial cancer surgery and contralateral cancer diagnosis was 31.9 months (range: 9-54 mo) in the unilateral scan group and 31.7 months (range: 27-34 mo) in the bilateral scan group. Mean diameter of detected cancers was 2.2cm (range: 0.7-5.5cm) in the unilateral scan group and 1.0 cm (range: 0.4-2.0cm) in the bilateral scan group.

Introduction of bilateral MRI to preoperative evaluation in breast cancer patients increases contralateral breast cancer detection, potentially leading to the reduction of contralateral breast cancer recurrence at long-term FU.

Bilateral preoperative MRI evaluation for the contralateral breast in newly diagnosed breast cancer patients can lead to reduce contralateral breast cancer recurrence at long-term follow-up.

Kim, J, Cho, N, Moon, W, Chang, J, Kim, W, Lee, S, Bilateral Preoperative MR Examinations in Newly Diagnosed Breast Cancer Patients: Initial and Long-term Impact on Contralateral Breast Cancer Diagnosis.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11011024.html